To provide a safe and effective healthcare service to all our communities in the East of England Integrated Performance Report Meeting Date: March 2016 Data: The month of February (Jan for Clinical & HART) Integrated Performance Report 1
Performance Trust Dashboard Workforce Finance Clinical Integrated Performance Report 2
Quality Patient Safety Description Trend Analysis Number of Serious Incidents Actual number of incidents (as defined in reporting and investigation of serious incidents procedure) reported within the month SI s saw another drop in February Integrated Performance Report 3
Quality Patient Safety Description Trend Analysis Vehicle Cleanliness The number of audits reaching the cleanliness target of 95% Vehicle cleanliness figures remain above the target Fill Stations Cleanliness The performance of station cleanliness audits reaching the target of 95% Station cleanliness is above the target performance in February Integrated Performance Report 4
Quality - Clinical Effectiveness Description Trend Analysis Cardiac Arrest ACQI - ROSC % of all patients who had resuscitation commenced/ continued by EEAST following an out-of-hospital cardiac arrest who had return of spontaneous circulation (ROSC) on arrival at hospital. This is the third month in a row that this target has fallen. Looking at the national average figures for October on the NHS England data set for the latest set of figures published (October 2015), the Trust is the third highest for ROSC with a compliance figure of 30%. The national average for that month was 27.6%. The amount of patient we are getting a successful ROSC with has remained fairly constant, although the number of eligible patients has fluctuated widely. It is difficult to compare further due to the lag time for collection of national data, but there are on-going action plans to address the resuscitation decisions and treatment for patients via the ACLs and through PU. Cardiac Arrest ACQI Survival to discharge % of all patients who had resuscitation commenced/ continued by EEAST following an out-ofhospital cardiac arrest who were discharged from hospital alive Following a drop in this target over the last two months, this target has increased slightly but must be maintained. We are missing this target by one or two patients every month and, with the on-going work of the ACLs and the proposal of an Out of Hospital Cardiac Arrest Strategy, this figure should improve with continued and focused attention. *The latest National Average available from NHS England is for October 2015. The solid red line in the chart represents actual National Averages. Where the National Average line has red hashes, this indicates that the average for these months is not actual. STEMI ACQI Care Bundle % of all patients suffering a ST elevation myocardial infarction (STEMI) who received an appropriate care bundle (aspirin, GTN, and analgesia administered and two pain scores recorded) It is gratifying to see the continued increase in the care bundle compliance. This is the highest the Trust has achieved all year and is a reflection of the care that staff are receiving from our crews when they are having a heart attack. The Trust will not be complacent around this and a positive communication message will be sent to staff to ensure they know this target has been achieved with their efforts. *The latest National Average available from NHS England is for October 2015. The solid red line in the chart represents actual National Averages. Where the National Average line has red hashes, this indicates that the average for these months is not actual.. Integrated Performance Report 5
Quality - Clinical Effectiveness Description Trend Analysis STEMI ACQI time to PPCI treatment within 150 minutes* % of all STEMI patients who received primary percutaneous coronary intervention (PPCI) following direct admission to a PPCI centre whose PPCI treatment took place within 150 minutes of call. The Trust has seen a further increase in the transportation of patient to a PPCI centre within the 150 minute time window. This is a further target which has seen the highest compliance all year and this will also form part of the positive communication for the staff. The Trust will continue to focus attention on this to ensure this level of service for those suffering from a heart attack and requiring PPCI treatment. *The latest National Average available from NHS England is for October 2015. The solid red line in the chart represents actual National Averages. Where the National Average line has red hashes, this indicates that the average for these months is not actual. Stroke ACQI care bundle % of all patients with suspected new stroke or transient ischaemic attack (TIA) who receive an appropriate care bundle (FAST assessment, blood pressure and blood glucose measurement) The Trust has seen an increase following the drop in compliance from last month. This was also our highest patient cohort this year at 811; over 70 more patients than last month. The Trust knows it must work hard to enable patients who suffer a Stroke to receive the correct care in a timely manner. The ASLs will continue to work with staff and managers to support the care for Stroke patients. *The latest National Average available from NHS England is for October 2015. The solid red line in the chart represents actual National Averages. Where the National Average line has red hashes, this indicates that the average for these months is not actual. Stroke ACQI time to HASU within 60 minutes* % of all Face Arm Speech Test (FAST) positive stroke patients potentially eligible for stroke thrombolysis (within local guidelines) who arrived at a hyper acute stroke centre (HASU) within 60 minutes of call. The Trust has seen an increase in compliance this month for patients getting to a HASU within 60 minutes from the onset of their Stroke. The Trust saw its highest number of patients in this cohort this year at 340. This is only for patients who are eligible for treatment. The Trust will continue to work with commissioners, staff and patients to increase this figure. *The latest National Average available from NHS England is for October 2015. The solid red line in the chart represents actual National Averages. Where the National Average line has red hashes, this indicates that the average for these months is not actual. *There are recognised delays in producing these indicators, due to the complexity of collecting outcome data Integrated Performance Report 6
Quality Patient Safety Description Trend Analysis Number of Emergency Service Complaints Actual number of Emergency Service complaints received in full calendar month. Complaints continued at an elevated level in February Number of PTS Complaints Actual number of Patient Transport Services complaints received in full calendar month. In February the Patient Transport Services received 18 complaints, rising above the rolling average Number of Primary Care Service Complaints Actual number of Primary Care Service complaints received in full calendar month. In February the Primary Care Service received 4 complaints Integrated Performance Report 7
Performance Summary Performance remains challenged Activity is above contracted levels at 6.04% week ending 14/02/16 UHP is below core with added pressure from SAP abstractions for University Average abstractions at 35% + Delays at Hospital causing significant issues in delivering a safe and timely service Sickness levels at 5.4% Additional PAS now secured for period of 15/02/16 20/03/16 Cleric CAD now implemented in Norwich Deployment trial complete with good outcome Preparation for CQC Inspection underway Integrated Performance Report 8
Performance Monthly Performance YTD 999 Call Pick Up (Within 5 seconds) Hear & Treat: 3.5% 3424 Red 1 64.41% YTD 72.77% Red 2 53.55% YTD 61.74% Target 75% Target 75% Number of 999 Calls: 85918 Picked up within 5 sec: 95.44% Average Pick Up Time: 00:00:03 See & Treat: 52.1% 50674 Red 19 86.13% YTD 90.59% Green 1 67.52% YTD 76.63% Target 95% Target 75% In 20mins Green 2 63.90% YTD 74.50% Target 75% In 30mins See & Convey: 44.4% 43218 Urgent 60.63% YTD 68.40% Target 75% Integrated Performance Report 9
Performance Description Trend Analysis Red 1 Performance % of Red 1 ambulance Calls resulting in an emergency response arriving within 8 minutes. Target of 75% of Red 1 incidents receiving an on scene response within 8 minutes Red 1 performance dropped below the target for the 8 th time in 2015/16 with the target of 75% not being achieved last month Red 2 Performance % of Red 2 ambulance Calls resulting in an emergency response arriving within 8 minutes. Target of 75% of Red 2 incidents receiving an on scene response within 8 minutes Red 2 performance dropped below the target for the 11 th time in 2015/16 with the target of 75% not being achieved last month Red 19 Performance % of Red 1 or Red 2 ambulance Calls resulting in an emergency response (conveying response) arriving within 19 minutes. Target of 95% of Red 1 incidents receiving a conveying resource on scene within 19 minutes Red 19 performance remains below target for the 10 9h time in 2015/16 with the target of 95% not being achieved last month Integrated Performance Report 10
Performance Description Trend Analysis Green 1 % of Green 1 ambulance calls resulting in an emergency response arriving within 20 minutes. Target of 75% of Green 1 incidents receiving an on scene response within 20 minutes. Green 1 performance dropped was below the national target this month Green 2 Red 2 Performance Green 3 % of Green 2 ambulance calls resulting in an emergency response arriving within 30 minutes. Target of 75% of Green 2 incidents % receiving of Red an 2 ambulance on scene response Calls resulting within in 30 an minutes. emergency response arriving within 8 minutes. Target of 75% of Red 2 incidents receiving an on scene response within 8 % of Green minutes 3 ambulance calls resulting in a telephone assessment within 20 minutes. Target of 75% of Green 3 incidents receiving a telephone assessment within 20 minutes. Green 2 performance was below the 75% target this month. Red 2 performance dropped below the target for the 7 th time in 2015/16 with the target of 75% not being achieved last month Green 3 performance was above the 75% target for the 7 th month in a row this YTD There is no new data since Oct 15 on commissioners Green 4 % of Green 4 ambulance calls resulting in a telephone assessment within 60 minutes. Target of 75% of Green 4 incidents receiving a telephone assessment within 60 minutes. Red 19 performance Green remains 4 performance below target was for the above 6 th time the 75% in 2015/16 target for with the 7target th month of 95% in a not row being this YTD achieved - There is last no new month data since Oct 15 on commissioners Integrated Performance Report 11
Performance Description Trend Analysis Urgent % of Urgent ambulance Calls resulting in a response arriving within the agreed pickup time There is a target of meeting the criteria in 75% of cases Hospital Handover & Turnaround A 15 minute arrival to handover (where the patient is handed over to the receiving hospital or facility) and a 15 minute Handover to Clear (where the crews are able to clean the vehicle and make ready for the next incident). Turnaround time is total AtoH & HtoC The AtoH and HtoC times in Feb and YTD exceed the target time of 15minutes. The total turnaround time also exceeds the 30minute target Post Handover Breaches Measures as above where the Handover to Clear has exceeded 30 & 60 minutes There has been a small decrease in >30 & >60 minute delays for Feb compared to the previous month Integrated Performance Report 12
Performance Year to Date Red performance by CCG (April February 16) National Targets Red 1 = 75%, Red 2 = 75%, Red 19 = 95% Integrated Performance Report 13
Resourcing Monthly Total Coverage (Rostered) Abstractions Planned Overtime Worked Month Planned OT worked in A&E February 16 30614 Vacancies Beds and Herts Essex Norfolk, Suffolk and Cambs W Herts E&N Herts Bedford Luton W Essex SW Essex SE Essex NE Essex Mid Essex E Norfolk W NorfolkE Suffolk W Suffolk Waveney N Cambs S Cambs Vacancies 34.07 46.04 0 8 52.27 39.07 16.18 11.06 7.57-10 -8 6.5-4.2-1.7 3.2 5.7 Total 88.11 126.15-8.5 Integrated Performance Report 14
RED Tail Breaches (refer to associated performance report) Red Breaches All Red breaches have been on a continually upward trend since April 15 There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 17
Green Tail Breaches (refer to associated performance report) Green Breaches All Green breaches have been on a continually upward trend since April 15 There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 18
HART February 2016 There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 19
PTS Description Trend Analysis Arrivals (%) Outward Collection (%) Travel Time (IN/OUT) % patients arriving any time prior to appointment and up to 30 minutes late The target percentage is 95% % of patients collected within 60 minutes of scheduled made ready time The target percentage is 95% Time on vehicle should not exceed 90 minutes The target percentage is 95% The data provides an overall view of PTS performance however has not been broken down by contract. PTS have 30 contracts all with different KPI s, some having no KPI s at all. Whilst some KPI s will be common, such as vehicle cleanliness and access to hand gel, others will be contract dependent. For example West Essex contract arrival standard is 90% of patients shall arrive on time or up to 60 minutes before the appointment. The Suffolk contract states 90% of patients to arrive between 60 minutes before and 10 minutes before the appointment time. North Essex is 85% of patients on time or up to 60 minutes before. Gt Yarmouth and Waveney require 98% to arrive at or prior to their appointment time. As such it is impossible to determine a single reporting KPI on the Trust PTS performance Integrated Performance Report 20
Workforce Description Trend Turnover Rate (%) Monthly staff turnover for rolling 12 months 5.95% YTD Sickness ERS Sickness (%) Sickness calculated from ESR (Electronic Staff Record) within a calendar and is displayed on the right in a rolling 12 month format. 22.87% PDR Rate PDR Rate (%) PDR Rate in full calendar month for each department end of year target of 95%. Integrated Performance Report 21
Statutory/Mandatory Training There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 22
Finance There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 23
Ambulance Benchmarking CQI Data There has been a drop in >30 & >60 minute delays for November compared to the previous 2 months Integrated Performance Report 24
Trust Benchmarking Performance Red1 Trust comparison Last 4 weeks Red2 Trust comparison Last 4 weeks Red19 Trust comparison Last 4 weeks Integrated Performance Report 25